CSL I PENILAIAN STATUS GIZI PADA ANAK dr. A. Arwinny Asmasary, Sp.A.

Presentasi berjudul: "CSL I PENILAIAN STATUS GIZI PADA ANAK dr. A. Arwinny Asmasary, Sp.A."— Transcript presentasi:

1 CSL I PENILAIAN STATUS GIZI PADA ANAK dr. A. Arwinny Asmasary, Sp.A

2 Pemeriksaan Fisik pada anak meliputi Pemeriksaan Status gizi

3 01 LOREM IPSUM DOLOR SIT AMET,  Simple PowerPoint  Easy to change colors, photos and Text.  Get a modern PowerPoint Presentation that is beautifully designed. 02 LOREM IPSUM DOLOR SIT AMET,  Simple PowerPoint  Easy to change colors, photos and Text.  Get a modern PowerPoint Presentation that is beautifully designed. 03 LOREM IPSUM DOLOR SIT AMET,  Simple PowerPoint  Easy to change colors, photos and Text.  Get a modern PowerPoint Presentation that is beautifully designed. Penilaian Status Gizi: 1. Anthropometri (WHO/ CDC) -Indeks Berat Badan menurut Umur (BB/U) -Indeks Panjang Badan menurut Umur atau Tinggi Badan menurut Umur (PB/U atau TB/U) -Indeks Berat Badan menurut Panjang Badan/Tinggi Badan (BB/PB atau BB/TB) -Indeks Masa Tubuh menurut Umur (IMT/U) 2. Clinical (Marasmus, kwashiorkor or mixed) 3. Upper arm circumference (UAC)

4 Pengukuran Berat Badan -Timbangan bayi digunakan untuk menimbang anak sampai umur dua tahun atau selama anak masih bisa berbaring atau duduk dengan tenang. -Letakkan timbangan pada meja yang datar dan tidak mudah bergoyang. -Lihat posisi jarum atau angka harus menunjukkan ke angka 0 (nol). -Bayi sebaiknya telanjang, tanpa topi, kaus kaki, sarung tangan. -Baringkan bayi dengan hati-hati di atas timbangan. -Lihat jarum timbangan sampai berhenti. -Baca angka yang ditunjukkan oleh jarum timbangan atau angka timbangan. -Bila bayi terus menerus bergerak, perhatikan gerakan jarum, baca angka ditengah- tengah antara gerakan jarum ke kanan dan ke kiri. Baby Scale

5 NO ASPEK PENILAIAN 0 1 2 1. Mengucapkan Assalamualaikum Warahmatullahi Wabarakatuh kepada keluarga pasien 2.Menjelaskan tujuan pengukuran kepada keluarga pasien 3. Sebelum pasien ditempatkan di atas baby scale, letakkan timbangan di tempat datar dan dikalibrasi di titik nol. 2 Minta orang tua untuk melepas jaket dan popok sekali pakai pasien. Idealnya pada pemeriksaan ini, bayi tidak mengenakan pakaian. 3Tempatkan bayi di atas baby scale. 4Ukur berat badan bayi dan catat hasilnya. Pengukuran Berat Badan (Baby scale)

6 Pengukuran Berat Badan -Letakkan timbangan di lantai yang datar sehingga tidak mudah -Lihat posisi jarum atau angka harus menunjukkan ke angka 0 (nol) -Anak sebaiknya memakai baju sehari-hari yang tipis, tidak memakai alas kaki, jaket, topi, jam tangan, kalung, dan tidak memegang sesuatu. -Anak berdiri di atas timbangan tanpa dipegangi. -Lihat jarum timbangan sampai berhenti. -Baca angka yang ditunjukkan oleh jarum timbangan atau angka timbangan. -Bila anak terus menerus bergerak, perhatikan gerakan jarum, baca angka ditengah-tengah antara gerakan jarum ke kanan dan ke kiri Timbangan injak

7 Pengukuran Berat Badan (Timbangan injak) NoASPEK PENILAIANSkor 012 1Mengucapkan Assalamualaikum Warahmatullahi Wabarakatuh 2Menjelaskan tujuan pengukuran kepada keluarga pasien 3 Mempersiapkan instrumen dengan benar (meletakkan di tempat datar dan mudah dibaca hasilnya serta melakukan kalibrasi) 4 Mempersiapkanpasien (pakaian minimal/ khusus, melepas alas kaki, pasien diposisikan berdiri tegak. 5Membaca skala pada posisi yang benar 6Mengulangi pengukuran sebanyak 3x dan menghitung rata-rata pengukuran 7Mencatat hasil pengukuran

8 Pengukuran Panjang Badan (<2 thn) NoAspek PenilaianSkor 012 1 Mengucapkan Assalamualaikum Warahmatullahi Wabarakatuh dan memperkenalkan diri kepada keluarga pasien 2Menyebutkan tujuan pengukuran 3 Mempersiapkan instrumen (meletakkan meteran atau papan pengukur pada alas yang datar dan keras) 4Mengarahkan asisten untuk membantu pengukuran 5 Mempersiapkan bayi dengan benar (pakaian minimal, melepas alas kaki dan asesoris kepala) 6 Meletakkan bayi pada posisi yang benar (di tengah alas, telentang, lurus, asisten bertugas memfiksasi kepala dengan kedua tangan agar tetap menempel pada pembatas angka 0 (pembatas kepala). 7 Kepala bayi menempel pada pembatas angka 0 (nol). 7 Melakukan pengukuran panjang badan dengan benar (lutut ditekan agar lurus; dan tangan kanan menekan telapak kaki sehingga telapak kaki tegak lurus dengan sudut 90o) 8 Membaca skala pada posisi yang benar (di tepi luar pengukur). 9Mengulangi pengukuran sebanyak 3x dan menghitung rata- rata pengukuran 10Mencatat hasil pengukuran Bila anak umur 0-24 bulan diukur dengan posisi berdiri, maka hasil pengukurannya dikoreksi dengan menambahkan 0,7 cm

9 Pengukuran Tinggi Badan (>2thn) Bila anak umur di atas 24 bulan diukur dengan posisi terlentang, maka hasil pengukurannya dikoreksi dengan mengurangkan 0,7 cm. NoVariabelSkor 012 1. Mengucapkan Assalamualaikum Warahmatullahi Wabarakatuh kepada keluarga pasien 2.Menjelaskan tujuan pengukuran kepada keluarga pasien 3 Mempersiapkan instrumen dengan benar (meletakkan alat ukur pada posisi yang benar; melakukan kalibrasi) 4 Mempersiapkan pasien (melepas alas kaki, posisi antropometri, melepaskan asesoris kepala) 5 Menunjukkan posisi vertex dan frankfurt plane (posisi kepala menghadap ke depan) dengan benar 6 Melakukan pengukuran tinggi badan dengan benar (inspirasi/ ditekan perutnya; minimal 3 titik bagian belakang tubuh menempel dinding) 7Membaca skala pada posisi yang benar 8 Mengulangi pengukuran sebanyak 3x dan menghitung rata-rata pengukuran 9Mencatat hasil pengukuran TOTAL SKOR

10 Pengukuran Lingkar Kepala NOLANGKAH KLINISDILAKUK AN TIDAK DILAKUKAN 1. Mengucapkan Assalamualaikum Warahmatullahi Wabarakatuh kepada keluarga pasien 2. Menjelaskan kepada keluarga pasien mengenai prosedur pemeriksaan yang akan dilakukan. 3. Menanyakan tanggal lahir pasien, lalu hitung umur pasien. 4. Melepaskan topi, hiasan rambut, atau hiasan lainnya di kepala yang akan mengganggu pengukuran 5.Mengukur lingkar kepala dengan pita ukur yang tidak elastis, melingkar dari bagian atas alis, melewati bagian atas telinga, sampai bagian paling menonjol di belakang kepala

11 Pengukuran Lingkar Kepala 6.Membaca angka di pita ukur pada pertemuan di angka 0 (nol). 7. Memplot hasil pengukuran pada grafik lingkaran kepala Nelhause menurut umur dan jenis kelamin anak. 8. Menginterpretasi hasil pengukuran. Interpretasi : -Bila ukuran lingkaran kepala anak berada di dalam ”jalur hijau” maka lingkaran kepala anak normal. -Bila ukuran lingkaran kepala anak berada di luar ”jalur hijau” maka lingkaran kepala anak tidak normal, yaitu makrosefali bila berada di atas ”jalur hijau” dan mikrosefali bila berada di bawah ”jalur hijau”. 9.Menjelaskan hasil pengukuran ke keluarga pasien:  Jika hasil normal, maka dilakukan pengukuran kembali setiap 3 bulan hingga usia 2 tahun dan setiap 6 bulan pada usia diatas 2 tahun.  Jika hasil tidak normal, maka akan dilakukan anamnesis lanjut dan pemeriksaan fisik secara menyeluruh, lalu dirujuk ke dokter spesialis anak bagian tumbuh kembang

12 IndeksKategori Status GiziAmbang Batas (Z-Score) Berat Badan menurut Umur (BB/U) anak usia 0 - 60 bulan Berat badan sangat kurang (severely underweight) <-3 SD Berat badan kurang (underweight) - 3 SD sd <- 2 SD Berat badan normal-2 SD sd +1 SD Risiko Berat badan lebih1> +1 SD Panjang Badan atau Tinggi Badan menurut Umur (PB/U atau TB/U) anak usia 0 - 60 bulan Sangat pendek (severely stunted) <-3 SD Pendek (stunted)- 3 SD sd <- 2 SD Normal-2 SD sd +3 SD Tinggi2> +3 SD Berat Badan menurut Panjang Badan atau Tinggi Badan (BB/PB atau BB/TB) anak usia 0 - 60 bulan Gizi buruk (severely wasted) <-3 SD Gizi kurang (wasted)- 3 SD sd <- 2 SD Gizi baik (normal)-2 SD sd +1 SD Berisiko gizi lebih (possible risk of overweight) > + 1 SD sd + 2 SD Gizi lebih (overweight)> + 2 SD sd + 3 SD Obesitas (obese)> + 3 SD Indeks Massa Tubuh menurut Umur (IMT/U) anak usia 0 - 60 bulan Gizi buruk (severely wasted)3 <-3 SD Gizi kurang (wasted)3- 3 SD sd <- 2 SD Gizi baik (normal)-2 SD sd +1 SD Berisiko gizi lebih (possible risk of overweight) > + 1 SD sd + 2 SD Gizi lebih (overweight)> + 2 SD sd +3 SD Obesitas (obese)> + 3 SD

13 Laki-laki Perempuan

14 Contoh soal: Anak laki-laki, usia 3 tahun 2 bulan datang ke PKM dibawa oleh ibunya. Ibu mengatakan bahwa berat badan anak tidak naik dalam beberapa bulan terakhir. Dari pemeriksaan fisik ditemukan adanya wasting dan iga gambang, wajah tampak old man face, anak rewel. Saat di PKM didapatkan BB: 10 kg, TB: 95 cm. Tentukan status gizi!

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17 Case Kemenkes RI. Pencegahan dan Tatalaksana Gizi Buruk pada Balita. 2019. 117 hal.

18 Kesimpulan contoh soal 1: Status Gizi: BB/TB: Terletak dibawah -3SD  Gizi Buruk TB/U : Terletak antara 0 dan -2SD  Perawakan normal BB/U : Terletak dibawah -3SD  Berat badan sangat kurang

19 Contoh soal 2: Anak perempuan, usia 1 tahun 6 bulan datang ke PKM dibawa oleh ibunya. Ibu mengatakan bahwa berat badan anak tidak naik dalam beberapa bulan terakhir. Saat di PKM didapatkan BB: 6 kg, TB: 70 cm. Tentukan status gizi!

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23 Kesimpulan contoh soal 2: Status Gizi: BB/TB: Terletak dibawah -3SD  Gizi Buruk TB/U : Terletak dibawah -3SD  Perawakan pendek BB/U : Terletak dibawah -3SD  Berat badan sangat kurang

24 Contoh soal 3: Anak perempuan kelas 2SD, usia 8 tahun. Ibu mengatakan bahwa anak kelihatan kecil dibanding temannya. BB: 18 kg, TB: 125 cm. Tentukan status gizi

25 BB/U: 18/26 X 100% = 69% (Berat badan kurang) TB/U: 125/127 X 100% = 98% (Perawakan normal) BB/TB: 18/24 X 100% = 75% (Gizi kurang)

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62 You can simply impress your audience and add a unique zing and appeal to your Presentations. Easy to change colors, photos and Text. I hope and I believe that this Template will your Time, Money and Reputation. You can simply impress your audience and add a unique zing and appeal to your Presentations. Easy to change colors, photos and Text. Easy to change colors, photos and Text. I hope and I believe that this Template will your Time, Money and Reputation. You can simply impress your audience and add a unique zing and appeal to your Presentations. Easy to change colors, photos and Text. I hope and I believe that this Template will your Time, Money and Reputation. You can simply impress your audience and add a unique zing and appeal to your Presentations. I hope and I believe that this Template will your Time, Money and Reputation. Get a modern PowerPoint Presentation that is beautifully designed. You can simply impress your audience and add a unique zing and appeal to your Presentations. You can simply impress your audience and add a unique zing and appeal to your Presentations. Easy to change colors, photos and Text. I hope and I believe that this Template will your Time, Money and Reputation. You can simply impress your audience and add a unique zing and appeal to your Presentations. Easy to change colors, photos and Text. Easy to change colors, photos and Text. I hope and I believe that this Template will your Time, Money and Reputation. You can simply impress your audience and add a unique zing and appeal to your Presentations. Easy to change colors, photos and Text. I hope and I believe that this Template will your Time, Money and Reputation. You can simply impress your audience and add a unique zing and appeal to your Presentations. I hope and I believe that this Template will your Time, Money and Reputation. Get a modern PowerPoint Presentation that is beautifully designed. You can simply impress your audience and add a unique zing and appeal to your Presentations. Column Style

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64 THANK YOU Insert the Subtitle of Your Presentation

65 Fully Editable Shapes

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67 You can Resize without losing quality You can Change Fill Color & Line Color www.allppt.com FREE PPT TEMPLATES Fully Editable Icon Sets: A

68 You can Resize without losing quality You can Change Fill Color & Line Color www.allppt.com FREE PPT TEMPLATES Fully Editable Icon Sets: B

69 You can Resize without losing quality You can Change Fill Color & Line Color www.allppt.com FREE PPT TEMPLATES Fully Editable Icon Sets: C